The objective of this prospective, real-world evidence/pragmatic study with a quality improvement program approach is to evaluate the feasibility and effectiveness of a community-engaged nutrition-focused program utilizing nutrition screening, education, supplementation and continuous follow up for children and their families.

Household Component

Inclusion

• Children aged 1-5 years experiencing stunting or its risk (defined as HAZ ≤ -1 SD at baseline)
• Children's legal guardian agrees to participate in the study
• Full term pregnancy (defined as ≥ 37 weeks gestation and ≥ 2500g birth weight)
• Residence in study area attending Children International (NGO) centers

Exclusion

• Children who have current medical conditions requiring hospitalization: gastrointestinal tract infections or inflammatory bowel disease; active tuberculosis; acute hepatitis B or C; human immunodeficiency virus OR malignancy; cystic fibrosis; immunodeficiency syndromes, congenital abnormalities of the respiratory tract, such as lung and respiratory cilia; an unsuspected foreign body in the respiratory tract; asthma; heart abnormalities; abdominal hernias; and known metabolic disorders, renal impairment, or rheumatic diseases and diabetes

• Congenital condition
• Children with disabilities such as cerebral palsy, autism spectrum disorder, neurodegenerative disorders
• Children with chronic or acute infections e.g. HIV, malaria
• Children who are taking medications or other agents that could potentially affect body weight, including diuretics, appetite stimulants, steroids, and growth hormones
• Children who have genetic conditions impacting weight status such as but not limited to: Bardet-Biedl Syndrome, Prader-Willi Syndrome
• Children already enrolled in a nutrition program that includes a supplement
• Participant has an allergy or intolerance to any ingredient in the study supplement, as reported by the parent.
• Children with sleep disorders such as but not limited to: obstructive sleep apnea, insomnia, parasomnias (sleepwalking, night terrors, bedwetting), delayed sleep phase syndrome, behavioral sleep disorders, circadian rhythm disorders
• Mental health disorders such as but not limited to: anxiety, depression

Organization Component

Inclusion

• NGO staff taking part in nutrition screenings
• Agrees to participate in survey

Exclusion

• Not involved in the implementation of the study
• Not involved in working with pediatric stunting or its risk
• Declines participation in survey

Via screening by existing community-based programming via Children International (NGO)